The MCV/HIV Mini Mental Health Center (MMHC) will provide comprehensive, mental health/substance abuse services to adults with HIV/AIDS. Clients will come from the Medical College of Virginia (MCV) Infectious Disease (ID) Clinic and the Richmond community. The ID Clinic currently provides medical care to more than 1000 HIV infected individuals, 42% of whom have AIDS. The project plan calls for ID Clinic admissions and community referrals to be screened in the following primary domains: psychiatric, neuro- psychologic, and substance abuse. Additionally, HIV transmission risk behavior, quality of life, social support, coping style, and health related locus of control will be assessed as these variables mediate mental health/ substance abuse treatment outcomes. Based on findings, the MMHC multi-disciplinary treatment team will provide services ranging from individual therapy/drug counseling, case management, and medication management to HIV transmission risk reduction training, cognitive re- training, "spirituality" and parenting classes. HIV/AIDS clients who refuse mental health services will be followed as a comparison group with focus on medical outcomes and service utilization rates. MMHC services will compliment those currently available in the community; the goal is to fill service gaps rather than to duplicate. In particular, we will focus on underserved groups such as parenting women, cocaine abusers, and those with early dementia. The MCV AIDS program has ties with numerous community mental health/substance abuse agencies; however, the availability of new services will enhance cooperation significantly. Services will be available at no charge to indigent clients. In order to minimize the impact of known treatment barriers, bus tickets will be provided and on-site babysitting will be available. The project evaluation plan encompasses four areas: l) client 2) curriculum 3) program and 4) health care delivery system. In addition to assessing client change as a function of treatment, we will evaluate an HIV/AIDS psychoeducational program, medical compliance, rates of service utilization, and staff stress levels prior to and following MMHC implementation. MMHC clients will be assessed at intake, at discharge, and at 6-month follow-up whenever possible; they will be paid for providing follow-up information. Staff measures will be administered every six months. Qualitative data will also be considered. Both staff and clients will be asked to evaluate the program at regular intervals via anonymous questionnaires and exit interviews will be part of the discharge planning process. Finally, staff will participate in semi-annual retreats to evaluate the overall impact of the program and generate recommendations for program modifications and enhancements. Through these evaluative mechanisms, the MMHC program hopes to be appropriately responsive to MCV's ever-changing HIV/AIDS population.